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Chen LL, Lauwers I, Verduijn G, Philippens M, Gahrmann R, Capala ME, Petit S. MRI for Differentiation between HPV-Positive and HPV-Negative Oropharyngeal Squamous Cell Carcinoma: A Systematic Review. Cancers (Basel) 2024; 16:2105. [PMID: 38893224 PMCID: PMC11171338 DOI: 10.3390/cancers16112105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Human papillomavirus (HPV) is an important risk factor for oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive (HPV+) cases are associated with a different pathophysiology, microstructure, and prognosis compared to HPV-negative (HPV-) cases. This review aimed to investigate the potential of magnetic resonance imaging (MRI) to discriminate between HPV+ and HPV- tumours and predict HPV status in OPSCC patients. A systematic literature search was performed on 15 December 2022 on EMBASE, MEDLINE ALL, Web of Science, and Cochrane according to PRISMA guidelines. Twenty-eight studies (n = 2634 patients) were included. Five, nineteen, and seven studies investigated structural MRI (e.g., T1, T2-weighted), diffusion-weighted MRI, and other sequences, respectively. Three out of four studies found that HPV+ tumours were significantly smaller in size, and their lymph node metastases were more cystic in structure than HPV- ones. Eleven out of thirteen studies found that the mean apparent diffusion coefficient was significantly higher in HPV- than HPV+ primary tumours. Other sequences need further investigation. Fourteen studies used MRI to predict HPV status using clinical, radiological, and radiomics features. The reported areas under the curve (AUC) values ranged between 0.697 and 0.944. MRI can potentially be used to find differences between HPV+ and HPV- OPSCC patients and predict HPV status with reasonable accuracy. Larger studies with external model validation using independent datasets are needed before clinical implementation.
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Affiliation(s)
- Linda L. Chen
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (G.V.); (M.E.C.)
| | - Iris Lauwers
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (G.V.); (M.E.C.)
| | - Gerda Verduijn
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (G.V.); (M.E.C.)
| | - Marielle Philippens
- Department of Radiotherapy, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands;
| | - Marta E. Capala
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (G.V.); (M.E.C.)
| | - Steven Petit
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (G.V.); (M.E.C.)
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Zhang L, Meng Z, Huang C, Xian J. Combined average standard uptake value and rate constant can predict expression of EGFR in hypopharyngeal squamous cell carcinoma: A pilot study with integrated PET/MRI. Eur J Radiol 2024; 172:111326. [PMID: 38280301 DOI: 10.1016/j.ejrad.2024.111326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/09/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE To investigate whether the quantitative multiparameters of 18F-FDG PET/MRI can predict expression of epidermal growth factor receptor (EGFR) of hypopharyngeal squamous cell carcinoma (HSCC). METHODS Twenty-one patients with HSCC confirmed by biopsy underwent neck integrated 18F-FDG PET/MRI and EGFR expression detection. Quantitative parameters derived from 18F-FDG PET, difusion-weighted imaging (DWI), and dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) were measured. The efficacies of quantitative multiparameters derived from 18F-FDG PET/MRI for predicting the expression of EGFR of HSCC were evaluated. RESULTS The patients were divided into positive expression group (PEG, n = 14) and negative expression group (NEG, n = 7). Mann-Whitney U nonparametric test showed that SUVmean and Kep had statistical difference between PEG and NPG, while other parameters had no statistical difference. Using 14.50 and 2.10 min-1 as the threshold values, areas under the curve (AUCs) for SUVmean and Kep were 0.786 with specificity of 92.9 % and sensitivity of 57.1 %. The combined use of SUVmean and Kep had better efficacy to evaluate the expression of EGFR with AUC of 0.980, sensitivity of 92.9 %, and specificity of 100.0 %. CONCLUSION Combined use of SUVmean and Kep showed good performance in predicting the expression of EGFR in HSCC. Integrated 18F-FDG PET/MRI enables simultaneous acquisition of SUVmean and Kep, so it represents as a powerful tool to noninvasively and repeatably evaluate the expression of EGFR during the management of HSCC.
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Affiliation(s)
- Lingyu Zhang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang Street, Dongcheng District, Beijing 100730, China
| | - Zhaoting Meng
- Department of Nuclear Medicine, Beijing Universal Medical Imaging Diagnostic Center, Beijing 100071, China
| | - Caiyun Huang
- Department of Radiology, Guangxi Medical University Cancer Hospital, Nanning 530022, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang Street, Dongcheng District, Beijing 100730, China.
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Jo KH, Kim J, Cho H, Kang WJ, Lee SK, Sohn B. 18F-FDG PET/CT Parameters Enhance MRI Radiomics for Predicting Human Papilloma Virus Status in Oropharyngeal Squamous Cell Carcinoma. Yonsei Med J 2023; 64:738-744. [PMID: 37992746 PMCID: PMC10681825 DOI: 10.3349/ymj.2023.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/26/2023] [Accepted: 08/17/2023] [Indexed: 11/24/2023] Open
Abstract
PURPOSE Predicting human papillomavirus (HPV) status is critical in oropharyngeal squamous cell carcinoma (OPSCC) radiomics. In this study, we developed a model for HPV status prediction using magnetic resonance imaging (MRI) radiomics and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters in patients with OPSCC. MATERIALS AND METHODS Patients with OPSCC who underwent 18F-FDG PET/CT and contrast-enhanced MRI before treatment between January 2012 and February 2020 were enrolled. Training and test sets (3:2) were randomly selected. 18F-FDG PET/CT parameters and MRI radiomics feature were extracted. We developed three light-gradient boosting machine prediction models using the training set: Model 1, MRI radiomics features; Model 2, 18F-FDG PET/CT parameters; and Model 3, combination of MRI radiomics features and 18F-FDG PET/CT parameters. Area under the receiver operating characteristic curve (AUROC) values were used to analyze the performance of the models in predicting HPV status in the test set. RESULTS A total of 126 patients (118 male and 8 female; mean age: 60 years) were included. Of these, 103 patients (81.7%) were HPV-positive, and 23 patients (18.3%) were HPV-negative. AUROC values in the test set were 0.762 [95% confidence interval (CI), 0.564-0.959], 0.638 (95% CI, 0.404-0.871), and 0.823 (95% CI, 0.668-0.978) for Models 1, 2, and 3, respectively. The net reclassification improvement of Model 3, compared with that of Model 1, in the test set was 0.119. CONCLUSION When combined with an MRI radiomics model, 18F-FDG PET/CT exhibits incremental value in predicting HPV status in patients with OPSCC.
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Affiliation(s)
- Kwan Hyeong Jo
- Department of Nuclear Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jinna Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hojin Cho
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Jun Kang
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Beomseok Sohn
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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van der Hulst HJ, Jansen RW, Vens C, Bos P, Schats W, de Jong MC, Martens RM, Bodalal Z, Beets-Tan RGH, van den Brekel MWM, de Graaf P, Castelijns JA. The Prediction of Biological Features Using Magnetic Resonance Imaging in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:5077. [PMID: 37894447 PMCID: PMC10605807 DOI: 10.3390/cancers15205077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Magnetic resonance imaging (MRI) is an indispensable, routine technique that provides morphological and functional imaging sequences. MRI can potentially capture tumor biology and allow for longitudinal evaluation of head and neck squamous cell carcinoma (HNSCC). This systematic review and meta-analysis evaluates the ability of MRI to predict tumor biology in primary HNSCC. Studies were screened, selected, and assessed for quality using appropriate tools according to the PRISMA criteria. Fifty-eight articles were analyzed, examining the relationship between (functional) MRI parameters and biological features and genetics. Most studies focused on HPV status associations, revealing that HPV-positive tumors consistently exhibited lower ADCmean (SMD: 0.82; p < 0.001) and ADCminimum (SMD: 0.56; p < 0.001) values. On average, lower ADCmean values are associated with high Ki-67 levels, linking this diffusion restriction to high cellularity. Several perfusion parameters of the vascular compartment were significantly associated with HIF-1α. Analysis of other biological factors (VEGF, EGFR, tumor cell count, p53, and MVD) yielded inconclusive results. Larger datasets with homogenous acquisition are required to develop and test radiomic-based prediction models capable of capturing different aspects of the underlying tumor biology. Overall, our study shows that rapid and non-invasive characterization of tumor biology via MRI is feasible and could enhance clinical outcome predictions and personalized patient management for HNSCC.
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Affiliation(s)
- Hedda J. van der Hulst
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
| | - Robin W. Jansen
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Conchita Vens
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- School of Cancer Science, University of Glasgow, Glasgow G61 1QH, UK
| | - Paula Bos
- Department of Radiation Oncology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Winnie Schats
- Scientific Information Service, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Marcus C. de Jong
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Roland M. Martens
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Zuhir Bodalal
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
| | - Regina G. H. Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Michiel W. M. van den Brekel
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Department of Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Jonas A. Castelijns
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
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Choi J, Huell D, Ucisik FE, Learned K. Malignant and Nonmalignant Lesions of the Oral Cavity. Oral Maxillofac Surg Clin North Am 2023:S1042-3699(23)00010-9. [PMID: 37032182 DOI: 10.1016/j.coms.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
There is a broad spectrum of pathology that occurs in the oral cavity. Knowledge of the different anatomic subsites and contents of each is important for accurate diagnosis and treatment. Oral cavity tumors are predominantly malignant in nature, but there are many nonmalignant lesions of which the practicing clinician should be aware. This article will discuss the anatomy, imaging approaches, and imaging characteristics of nonmalignant and malignant pathology in the oral cavity.
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Affiliation(s)
- Jeanie Choi
- Department of Neuroradiology, Division of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1482, Houston, TX 77030, USA.
| | - Derek Huell
- New York University Grossman School of Medicine, 550 1st Avenue, New York, NY 10016, USA
| | - Fehime Eymen Ucisik
- Department of Neuroradiology, Division of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1482, Houston, TX 77030, USA
| | - Kim Learned
- Department of Neuroradiology, Division of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1482, Houston, TX 77030, USA
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6
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Chen Y, Dang H, Wu X, Zhang Z, Shi X, Zhang T, Chen X, Zhu X, Su T, Wang Y, Hou B, Jin Z. Correlation between 18F-FDG PET/MR parameters with the expression level of epidermal growth factor receptor and the diagnostic value of PET/MR in head and neck squamous cell carcinoma. Heliyon 2023; 9:e14822. [PMID: 37089359 PMCID: PMC10119563 DOI: 10.1016/j.heliyon.2023.e14822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Objective To investigate the correlation between parameters of PET/MR and the expression level of epidermal growth factor receptor (EGFR) in head and neck squamous cell carcinoma (HNSCC) and to evaluate diagnostic efficacy of independent and combined PET/MR parameters for the expression level of EGFR. Materials and methods 21 patients who had undergone PET/MR and been proven HNSCC pathologically were included in this retrospective study. The PET/MR sequences included 18-flurodeoxyglucose (18F-FDG) PET, T1, T2-weighted imaging, DWI, ADC and DCE. Parameters including ADCmean from DWI, Ktrans, Ve, Kep from DCE, and SUVmean, SUVmax from PET were obtained. Immunohistochemical method was used to detect the expression level of EGFR. The associations between parameters of PET/MR and EGFR expression level were analyzed by Spearman's analysis. Logistic regression was utilized to establish the diagnostic model of EGFR expression level with PET/MR parameters. The efficacy of the independent and combined diagnostic model for EGFR expression level in HNSCC was analyzed by ROC curve. P value ≤ 0.05 was considered statistically significant. Results (1) Expression level of EGFR was correlated to SUVmean with correlation coefficient of 0.47 (p = 0.05). (2) There was significant difference of SUVmean between the EGFR high- and low-expression groups (p = 0.02). (3) Combination of PET/MR improved the diagnostic efficacy for expression level of EGFR, with AUC = 0.93. Conclusion There were different degrees of correlation between PET/MR parameters and EGFR expression level in HNSCC. Combination of PET/MR might improve diagnostic efficacy of EGFR expression level.
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Affiliation(s)
- Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
| | - Haodan Dang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, Fuxing Road 28, Beijing, China
| | - Xiaoqian Wu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- Corresponding author.
| | - Xiaohua Shi
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuai Fu Yuan 1, Dong Cheng District, Beijing 100730, China
| | - Xingming Chen
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuai Fu Yuan 1, Dong Cheng District, Beijing 100730, China
| | - Xiaoli Zhu
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuai Fu Yuan 1, Dong Cheng District, Beijing 100730, China
| | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
| | - Bo Hou
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
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Romeo V, Stanzione A, Ugga L, Cuocolo R, Cocozza S, Quarantelli M, Chawla S, Farina D, Golay X, Parker G, Shukla-Dave A, Thoeny H, Vidiri A, Brunetti A, Surlan-Popovic K, Bisdas S. Clinical indications and acquisition protocol for the use of dynamic contrast-enhanced MRI in head and neck cancer squamous cell carcinoma: recommendations from an expert panel. Insights Imaging 2022; 13:198. [PMID: 36528678 PMCID: PMC9759606 DOI: 10.1186/s13244-022-01317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The clinical role of perfusion-weighted MRI (PWI) in head and neck squamous cell carcinoma (HNSCC) remains to be defined. The aim of this study was to provide evidence-based recommendations for the use of PWI sequence in HNSCC with regard to clinical indications and acquisition parameters. METHODS Public databases were searched, and selected papers evaluated applying the Oxford criteria 2011. A questionnaire was prepared including statements on clinical indications of PWI as well as its acquisition technique and submitted to selected panelists who worked in anonymity using a modified Delphi approach. Each panelist was asked to rate each statement using a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). Statements with scores equal or inferior to 5 assigned by at least two panelists were revised and re-submitted for the subsequent Delphi round to reach a final consensus. RESULTS Two Delphi rounds were conducted. The final questionnaire consisted of 6 statements on clinical indications of PWI and 9 statements on the acquisition technique of PWI. Four of 19 (21%) statements obtained scores equal or inferior to 5 by two panelists, all dealing with clinical indications. The Delphi process was considered concluded as reasons entered by panelists for lower scores were mainly related to the lack of robust evidence, so that no further modifications were suggested. CONCLUSIONS Evidence-based recommendations on the use of PWI have been provided by an independent panel of experts worldwide, encouraging a standardized use of PWI across university and research centers to produce more robust evidence.
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Affiliation(s)
- Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.,Interdepartmental Research Center on Management and Innovation in Healthcare - CIRMIS, University of Naples Federico II, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Mario Quarantelli
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Davide Farina
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK.,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK
| | - Geoff Parker
- Department of Computer Science, Centre for Medical Image Computing, Queen Square Institute of Neurology, University College London, London, UK
| | - Amita Shukla-Dave
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Departments of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Harriet Thoeny
- Department of Radiology, Cantonal Hospital Fribourg, University of Fribourg, Fribourg, Switzerland
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Sotirios Bisdas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK. .,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK.
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8
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Touska P, Connor S. Imaging of human papilloma virus associated oropharyngeal squamous cell carcinoma and its impact on diagnosis, prognostication, and response assessment. Br J Radiol 2022; 95:20220149. [PMID: 35687667 PMCID: PMC9815738 DOI: 10.1259/bjr.20220149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/22/2022] [Accepted: 06/07/2022] [Indexed: 01/13/2023] Open
Abstract
The clinical behaviour and outcomes of patients with oropharyngeal cancer (OPC) may be dichotomised according to their association with human papilloma virus (HPV) infection. Patients with HPV-associated disease (HPV+OPC) have a distinct demographic profile, clinical phenotype and demonstrate considerably better responses to chemoradiotherapy. This has led to a reappraisal of staging and treatment strategies for HPV+OPC, which are underpinned by radiological data. Structural modalities, such as CT and MRI can provide accurate staging information. These can be combined with ultrasound-guided tissue sampling and functional techniques (such as diffusion-weighted MRI and 18F-fludeoxyglucose positron emission tomography-CT) to monitor response to treatment, derive prognostic information, and to identify individuals who might benefit from intensification or deintensification strategies. Furthermore, advanced MRI techniques, such as intravoxel incoherent motion and perfusion MRI as well as application of artificial intelligence and radiomic techniques, have shown promise in treatment response monitoring and prognostication. The following review will consider the contemporary role and knowledge on imaging in HPV+OPC.
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Affiliation(s)
- Philip Touska
- Department of Radiology, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
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9
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Park YM, Lim JY, Koh YW, Kim SH, Choi EC. Machine learning and magnetic resonance imaging radiomics for predicting human papilloma virus status and prognostic factors in oropharyngeal squamous cell carcinoma. Head Neck 2022; 44:897-903. [PMID: 35044020 DOI: 10.1002/hed.26979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 12/16/2021] [Accepted: 01/10/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We attempted to predict pathological factors and treatment outcomes using machine learning and radiomic features extracted from preoperative magnetic resonance imaging (MRI) of oropharyngeal squamous cell carcinoma (OPSCC) patients. METHODS The medical records and imaging data of 155 patients who were diagnosed with OPSCC were analyzed retrospectively. RESULTS The logistic regression model showed that the area under the receiver operating characteristic curve (AUC) of the model was 0.792 in predicting human papilloma virus (HPV) status. The LightGBM model showed an AUC of 0.8333 in predicting HPV status. The performance of the logistic model in predicting lymphovascular invasion, extracapsular nodal spread, and metastatic lymph nodes showed AUC values of 0.7871, 0.6713, and 0.6638, respectively. In predicting disease recurrence, the LightGBM model showed an AUC of 0.8571. In predicting patient death, the logistic model showed an AUC of 0.8175. CONCLUSIONS A machine learning model using MRI radiomics showed satisfactory performance in predicting pathologic factors and treatment outcomes of OPSCC patients.
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Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
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10
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Salzillo TC, Taku N, Wahid KA, McDonald BA, Wang J, van Dijk LV, Rigert JM, Mohamed ASR, Wang J, Lai SY, Fuller CD. Advances in Imaging for HPV-Related Oropharyngeal Cancer: Applications to Radiation Oncology. Semin Radiat Oncol 2021; 31:371-388. [PMID: 34455992 DOI: 10.1016/j.semradonc.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
While there has been an overall decline of tobacco and alcohol-related head and neck cancer in recent decades, there has been an increased incidence of HPV-associated oropharyngeal cancer (OPC). Recent research studies and clinical trials have revealed that the cancer biology and clinical progression of HPV-positive OPC is unique relative to its HPV-negative counterparts. HPV-positive OPC is associated with higher rates of disease control following definitive treatment when compared to HPV-negative OPC. Thus, these conditions should be considered unique diseases with regards to treatment strategies and survival. In order to sufficiently characterize HPV-positive OPC and guide treatment strategies, there has been a considerable effort to diagnose, prognose, and track the treatment response of HPV-associated OPC through advanced imaging research. Furthermore, HPV-positive OPC patients are prime candidates for radiation de-escalation protocols, which will ideally reduce toxicities associated with radiation therapy and has prompted additional imaging research to detect radiation-induced changes in organs at risk. This manuscript reviews the various imaging modalities and current strategies for tackling these challenges as well as provides commentary on the potential successes and suggested improvements for the optimal treatment of these tumors.
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Affiliation(s)
- Travis C Salzillo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Nicolette Taku
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Kareem A Wahid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Brigid A McDonald
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Jarey Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Lisanne V van Dijk
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Jillian M Rigert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Jihong Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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11
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MRI Dynamic Contrast Imaging of Oral Cavity and Oropharyngeal Tumors. Top Magn Reson Imaging 2021; 30:97-104. [PMID: 33828061 DOI: 10.1097/rmr.0000000000000283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT In the past decade, dynamic contrast-enhanced magnetic resonance imaging has had an increasing role in assessing the microvascular characteristics of various tumors, including head and neck cancer. Dynamic contrast-enhanced magnetic resonance imaging allows noninvasive assessment of permeability and blood flow, both important parametric features of tumor hypoxia, which is in turn a marker for treatment resistance for head and neck cancer.In this article we will provide a comprehensive review technique in evaluating tumor proliferation and application of its parameters in differentiating between various tumor types of the oral cavity and how its parameters can correlate between epidermal growth factor receptor and human papillomavirus which can have an implication in patient's overall survival rates.We will also review how the parameters of this method can predict local tumor control after treatment and compare its efficacy with other imaging modalities. Lastly, we will review how its parameters can be used prospectively to identify early complications from treatment.
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12
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Chawla S, Kim SG, Loevner LA, Wang S, Mohan S, Lin A, Poptani H. Prediction of distant metastases in patients with squamous cell carcinoma of head and neck using DWI and DCE-MRI. Head Neck 2020; 42:3295-3306. [PMID: 32737951 DOI: 10.1002/hed.26386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 05/30/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The primary purpose was to evaluate the prognostic potential of diffusion imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in predicting distant metastases in squamous cell carcinoma of head and neck (HNSCC) patients. The secondary aim was to examine differences in DWI and DCE-MRI-derived parameters on the basis of human papilloma virus (HPV) status, differentiation grade, and nodal stage of HNSCC. METHODS Fifty-six patients underwent pretreatment DWI and DCE-MRI. Patients were divided into groups who subsequently did (n = 12) or did not develop distant metastases (n = 44). Median values of apparent diffusion coefficient (ADC), volume transfer constant (Ktrans ), and mean intracellular water-lifetime (τi ) and volume were computed from metastatic lymph nodes and were compared between two groups. Prognostic utility of HPV status, differentiation grading, and nodal staging was also evaluated both in isolation or in combination with MRI parameters in distinguishing patients with and without distant metastases. Additionally, MRI parameters were compared between two groups based on dichotomous HPV status, differentiation grade, and nodal stage. RESULTS Lower but not significantly different Ktrans (0.51 ± 0.15 minute-1 vs 0.60 ± 0.05 minute-1 ) and not significantly different τi (0.13 ± 0.03 second vs 0.19 ± 0.02 second) were observed in patients who developed distant metastases than those who did not. Additionally, no significant differences in ADC or volume were found. τi, was the best parameter in discriminating two groups with moderate sensitivity (67%) and specificity (61.4%). Multivariate logistic regression analyses did not improve the overall prognostic performance for combination of all variables. A trend toward higher τi was observed in HPV-positive patients than those with HPV-negative patients. Also, a trend toward higher Ktrans was observed in poorly differentiated HNSCCs than those with moderately differentiated HNSCCs. CONCLUSION Pretreatment DCE-MRI may be useful in predicting distant metastases in HNSCC.
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Affiliation(s)
- Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sungheon G Kim
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Laurie A Loevner
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sumei Wang
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexander Lin
- Department of Radiation Oncology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Harish Poptani
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, UK
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13
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Sohn B, Choi YS, Ahn SS, Kim H, Han K, Lee SK, Kim J. Machine Learning Based Radiomic HPV Phenotyping of Oropharyngeal SCC: A Feasibility Study Using MRI. Laryngoscope 2020; 131:E851-E856. [PMID: 33070337 DOI: 10.1002/lary.28889] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate whether a radiomic MRI feature-based prediction model can differentiate oropharyngeal squamous cell carcinoma (SCC) according to the human papillomavirus (HPV) status. STUDY DESIGN Retrospective cohort study. METHODS Pretreatment MRI data from 62 consecutive patients with oropharyngeal SCC were retrospectively reviewed, and chronologically allocated to training (n = 43) and test sets (n = 19). Enhancing tumors were semi-automatically segmented on each slice of the postcontrast T1WI to span the entire tumor volume, after registration of T2WI to postcontrast T1WI; 170 radiomic features were extracted from the entire tumor volume. Relevant features were selected and radiomics models were trained using least absolute shrinkage and selection operator (LASSO) logistic regression model with 10-fold cross-validation, after subsampling of training sets using synthetic minority over-sampling technique to mitigate data imbalance. The selected features, weighted by their respective coefficients, were combined linearly to yield a radiomics score. The diagnostic performance of the radiomic score was evaluated using the area under the receiver operating characteristic curve (AUC). RESULTS Six radiomic features, which revealed strong association with HPV status of oropharyngeal SCC, were selected using LASSO. The radiomics model yielded excellent performance on the training set (AUC, 0.982 [95% CI, 0.942-1.000]) and moderate performance on the test set (AUC, 0.744 [95% CI, 0.496-0.991]) for differentiating oropharyngeal SCC according to HPV status. CONCLUSIONS Radiomics-based MRI phenotyping differentiates oropharyngeal SCC according to HPV status, and thus, is a potential imaging biomarker. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E851-E856, 2021.
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Affiliation(s)
- Beomseok Sohn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoon Seong Choi
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Hwiyoung Kim
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jinna Kim
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
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14
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Lee JY, Han M, Kim KS, Shin SJ, Choi JW, Ha EJ. Discrimination of HPV status using CT texture analysis: tumour heterogeneity in oropharyngeal squamous cell carcinomas. Neuroradiology 2019; 61:1415-1424. [PMID: 31641781 DOI: 10.1007/s00234-019-02295-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/20/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the diagnostic performance of texture analysis for discriminating human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (OPSCC) in the primary tumours and metastatic lymph nodes. METHODS Ninety-five patients with primary tumour and 91 with metastatic lymph nodes with confirmed HPV status, who underwent pretreatment contrast-enhanced CT (CECT), were included as the discovery population. CT texture analysis was performed using commercially available software. Differences between HPV-positive and HPV-negative groups were analysed using the χ2 test (or Mann-Whitney U test) and independent t test (or Fisher's exact test). ROC curve analysis was performed to discriminate HPV status according to heterogeneity parameters. Diagnostic accuracy was evaluated in the separate validation population (n = 36) from an outside hospital. RESULTS HPV positivity was 52.6% for primary tumours and 56.0% for metastatic lymph nodes. The entropy and standard deviation (SD) values in the HPV-positive group were significantly lower. Entropy using the medium filter was the best discriminator between HPV-positive and HPV-negative primary OPSCCs (AUC, 0.85) and SD without the filter for metastatic lymph nodes (AUC, 0.82). Diagnostic accuracy of entropy for the primary tumour was 80.0% in the discovery group and 75.0% in the validation group. In cases of metastatic lymph node, the accuracy of SD was 79.1% and 78.8%, respectively. CONCLUSION Significant differences were found in heterogeneity parameters from texture analysis of pretreatment CECT, according to HPV status. Texture analysis could be used as an adjunctive tool for diagnosis of HPV status in clinical practice.
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Affiliation(s)
- Ji Young Lee
- Department of Radiology, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Miran Han
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, 164, World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
| | - Kap Seon Kim
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, 164, World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Su-Jin Shin
- Department of Pathology, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Jin Wook Choi
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, 164, World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Eun Ju Ha
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, 164, World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
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15
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Vidiri A, Marzi S, Gangemi E, Benevolo M, Rollo F, Farneti A, Marucci L, Spasiano F, Sperati F, Di Giuliano F, Pellini R, Sanguineti G. Intravoxel incoherent motion diffusion-weighted imaging for oropharyngeal squamous cell carcinoma: Correlation with human papillomavirus Status. Eur J Radiol 2019; 119:108640. [DOI: 10.1016/j.ejrad.2019.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/17/2019] [Accepted: 08/11/2019] [Indexed: 01/04/2023]
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16
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Yang B, Dong K, Guo P, Guo P, Jie G, Zhang G, Li T. Identification of Key Biomarkers and Potential Molecular Mechanisms in Oral Squamous Cell Carcinoma by Bioinformatics Analysis. J Comput Biol 2019; 27:40-54. [PMID: 31424263 DOI: 10.1089/cmb.2019.0211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to explore the key genes, microRNA (miRNA), and the pathogenesis of oral squamous cell carcinoma (OSCC) at the molecular level through the analysis of bioinformatics, which could provide a theoretical basis for the screening of drug targets. Data of OSCC were obtained from Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) were identified via GEO2R analysis. Next, protein-protein interaction (PPI) network of DEGs was constructed through Search Tool for the Retrieval of Interacting Gene and visualized via Cytoscape, whereas the hub genes were screened out with Cytoscape. Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed by Database for Annotation, Visualization and Integrated Discovery. The miRNA, which might regulate hub genes, were screened out with TargetScan and GO and KEGG analysis of miRNA was performed by DNA Intelligent Analysis-miRPath. Survival analyses of DEGs were conducted via the Kaplan-Meier plotter. Finally, the relationships between gene products and tumors were analyzed by Comparative Toxicogenomics Database. A total of 121 differential genes were identified. One hundred thirty-five GO terms and 56 pathways were obtained, which were mainly related to PI3K-Akt signals pathway, FoxO signaling pathway, Wnt signaling pathway, cell cycle, p53 signaling pathway, cellular senescence, and other pathways; 10 genes were identified as hub genes through modules analyses in the PPI network. Finally, a survival analysis of 10 hub genes was conducted, which showed that the low expression of matrix metalloproteinase (MMP)1, MMP3, and C-X-C motif chemokine ligand (CXCL)1 and the high expression of CXCL9 and CXCL10 resulted in a significantly poor 5-year overall survival rate in patients with OSCC. In this study, the DEGs of OSCC was analyzed, which assists us in a systematic understanding of the pathogenicity underlying occurrence and development of OSCC. The MMP1, MMP3, CXCL1, CXCL9, and CXCL10 genes might be used as potential targets to improve diagnosis and as immunotherapy biomarkers for OSCC.
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Affiliation(s)
- Bao Yang
- Department of Stomatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Keqin Dong
- School of Basic Medical Sciences, Hebei Medical University, Shijiazhuang, China
| | - Peiyuan Guo
- School of Basic Medical Sciences, Hebei Medical University, Shijiazhuang, China
| | - Peng Guo
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guo Jie
- Department of Stomatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guanhua Zhang
- Department of Stomatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianke Li
- Department of Stomatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Han M, Lee S, Lee D, Kim S, Choi J. Correlation of human papilloma virus status with quantitative perfusion/diffusion/metabolic imaging parameters in the oral cavity and oropharyngeal squamous cell carcinoma: comparison of primary tumour sites and metastatic lymph nodes. Clin Radiol 2018; 73:757.e21-757.e27. [DOI: 10.1016/j.crad.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 04/11/2018] [Indexed: 12/26/2022]
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18
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Surov A, Meyer HJ, Leifels L, Höhn AK, Richter C, Winter K. Histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging can predict histopathological findings including proliferation potential, cellularity, and nucleic areas in head and neck squamous cell carcinoma. Oncotarget 2018; 9:21070-21077. [PMID: 29765520 PMCID: PMC5940412 DOI: 10.18632/oncotarget.24920] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/06/2018] [Indexed: 02/07/2023] Open
Abstract
Our purpose was to analyze possible associations between histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging DCE MRI and histopathological findings like proliferation index, cell count and nucleic areas in head and neck squamous cell carcinoma (HNSCC). 30 patients (mean age 57.0 years) with primary HNSCC were included in the study. In every case, histogram analysis parameters of Ktrans, Ve, and Kep were estimated using a mathlab based software. Tumor proliferation index, cell count, and nucleic areas were estimated on Ki 67 antigen stained specimens. Spearman's non-parametric rank sum correlation coefficients were calculated between DCE and different histopathological parameters. KI 67 correlated with Ktrans min (p = −0.386, P = 0.043) and s Ktrans skewness (p = 0.382, P = 0.045), Ve min (p = −0.473, P = 0.011), Ve entropy (p = 0.424, P = 0.025), and Kep entropy (p = 0.464, P = 0.013). Cell count correlated with Ktrans kurtosis (p = 0.40, P = 0.034), Ve entropy (p = 0.475, P = 0.011). Total nucleic area correlated with Ve max (p = 0.386, P = 0.042) and Ve entropy (p = 0.411, P = 0.030). In G1/2 tumors, only Ktrans entropy correlated well with total (P =0.78, P =0.013) and average nucleic areas (p = 0.655, P = 0.006). In G3 tumors, KI 67 correlated with Ve min (p = −0.552, P = 0.022) and Ve entropy (p = 0.524, P = 0.031). Ve max correlated with total nucleic area (p = 0.483, P = 0.049). Kep max correlated with total area (p = −0.51, P = 0.037), and Kep entropy with KI 67 (p = 0.567, P = 0.018). We concluded that histogram-based parameters skewness, kurtosis and entropy of Ktrans, Ve, and Kep can be used as markers for proliferation activity, cellularity and nucleic content in HNSCC. Tumor grading influences significantly associations between perfusion and histopathological parameters.
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Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Leonard Leifels
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Anne-Kathrin Höhn
- Department of Pathology University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Cindy Richter
- Institute of Anatomy, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Karsten Winter
- Institute of Anatomy, University Hospital of Leipzig, 04103 Leipzig, Germany
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